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2A - Stuff i just cannot remember > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

Gold standard investigation for suspected renal colic

A

Non-contrast CT Kidney, Ureter, Bladder

1L = X-ray KUB

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2
Q

Investigation for suspected renal colic if pregnant

A

Abdominal Ultrasound

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3
Q

Why do we not want to use contrast very often?

A

Contrast raises risk of anaphylactic reactions

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4
Q

Tamsulosin uses and pharmacology

A

Uses: BPH tx

A1-Adrenergic Antagonist

Blocks A1a and A1b receptors in the prostate > smooth muscle relaxation > better urine flow

Acts on GU AND vessel smooth muscle :. can cause low BP

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5
Q

What is the difference between alpha and beta adrenergic receptors

A

Alpha: stimulate effector cells - vasoconstrict
smooth muscle

Beta: relax effector cells - vasodilate smooth + cardiac muscle

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6
Q

Physiology + presentations of Nephritic Syndrome

A

Damaged glom. more permeable > protein from blood into nephron > PROTEINURIA

Albumin leaves blood > HYPOALBUMINAEMIA

Oncotic pressure falls (less protein in blood) > lowers osmotic pressure > water moves out of vessels into tissue > OEDEMA

Loss of protein > less lipid synthesis > more lipid remains in blood > HYPERLIPIDAEMIA, LIPIDURIA

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7
Q

What are we shitting our pants about when someone develops AKI

A

Hyperkalaemia

Bad kidney > can’t excrete K+ > hyperK > cardiac arrest

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8
Q

GFR Staging

A

*ml/min

1 : >90 + renal damage
2: 60-89 + renal damage 
3a: 45-59 +/- renal damage 
3b: 30-44 +/- renal damage 
4: 15-29 +/- renal damage
Stage 5: <15 = renal failure
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9
Q

Pt presents feeling nauseous with fatigue, pruritus, appetite-loss and restless legs, You note peripheral oedema and bloods show anaemia.

Likely diagnosis?

A

Chronic Kidney Disease

(Less EPO > Anaemia)

(Urea builds > n/v, metal-mouth, pruritus)

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10
Q

Pt presents with a abdominal lump and haematuria. They have a history of Hypertension and smoke.

Imaging shows Renal cysts. Likely diagnosis?

A

Polycystic Kidney disease

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11
Q

Pt presents with ^^oliguria, and a sharp creatinine rise.

Likely diagnosis? What electrolyte should you be worried of? What drug is contraindicated?

A

Acute Kidney Injury

Worry about Hyperkalaemia - tall T-waves

Dopamine contraindicated

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12
Q

Common causes of UTI?

A

KEEPS

Klebsiella - 10%
E coli - 80%
Enterococcus 
Proteus mirabilis - 5%
S saphrophyticus - 5%
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13
Q

Pt presents with dysuria and nocturia. Their wee is cloudy.

Likely cause?

A

UTI

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14
Q

Pt presents with haematuria, flank pain and an abdominal mass.

Genetic tests reveal a mutation in Chromosome 3.

Likely diagnosis?

A

Von Hippel Lindau = malignant cancer of the PCT Epithelium

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15
Q

What is the most common abdominal malignancy in children?

A

Wilms’ Tumour = Nephroblastoma

Primitive renal tubes + mesenchymal cells

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16
Q

GOLD surgical Management for BPH

A

TURP

17
Q

Gold medical management for BPH

2L management

A

alpha-blocker - Tamulosin, Doxazosin

5-a-reductase inhibitor

2L: Finasteride (hair)

18
Q

Pt presents with severe intermittent abdominal pain. The pain is felt on their right side and testicles.

Upon going to the toilet, they noticed red urine. Pt is apyrexial.

Likely diagnosis?
Investigations?

A

KIDNEY STONES
- side -> testicles (loin to groin)

GOLD: Non-contrast CT KUB

19
Q

Pt presents with painless haematuria. He works in a cloth-dying factory.

Likely diagnosis? RF? Investigations? Management?

A

Bladder Cancer - Transitional Cell Carcinoma

Investigations:
1L: Flexible cystoscopy
GOLD: CT Urogram

Management: TURBT
Transurethral Resection of Bladder Tumour
+ Mitomycin C Chemo
+ BCG immunotherapy (non-muscle invasive)

20
Q

Types of bladder cancer

A

Transitional Cell Carcinoma

Squamous Cell Carcinoma

Adenocarcinoma

Small Cell Bladder Cancer

21
Q

Risk factors for Transitional Cell Carcinoma (bladder)

A
  • SMOKING
  • Aromatic amines (rubber, dyes)
  • Cyclophosphamide

TCC SAC

22
Q

Risk factors for Squamous cell carcinoma (bladder)

A
  • Schistosomiasis infection

- Long-term catheter (10+ yr)

23
Q

Risk factors for Adenocarcinomas (bladder)

A
  • Local bowel cancer

- Other bladder cancers

24
Q

Risk factors for Small cell carcinomas (bladder)

A
  • Other bladder cancers
25
Q

Bladder cancer typically metastasises to…

A

Lungs
Liver
Bone

26
Q

Pt presents with painless haematuria.

Investigations?

A

Presume bladder cancer.

1L: Flexible cystoscopy

GOLD: CT Urogram (RF present)

USS KUB if no RF present

TURBT = Diagnostic AND therapeutic

27
Q

Management of Bladder cancer

A

TURBT: Transurethral Resection of Bladder Tumour

Intravesical therapy:

  • Mitomycin C chemo
  • BCG immunotherapy

Muscle-invasive:

  • Radical cystectomy
  • Ileal conduit
28
Q

Pt presents with discharge, fever, and testicular pain.

What investigation should you do to check for an STI?

A

Nucleic Acid Amplification test

  • chlamydia
  • gonorrhoea
29
Q

CKD Diagnosis

What diagnoses end-stage renal failure?

A

eGFR <60

  • 2 measurements
  • 3 months apart

<15 = end-stage renal failure

30
Q

What are the different types of renal cell carcinoma?

Which is most common?

A

1 CLEAR CELL CARCINOMA (75%)

31
Q

BPH Management

A

1L Alpha blocker
a) Tamsulosin

2L 5-alpha reductase inhibitor
a) Finasteride

SURGICAL: Transurethral Resection of Prostate (TURP)

32
Q

Overactive bladder management

A

1L Anticholinergic

a) Oxybutynin

33
Q

Management of breast CA in post-menopausal F/ Gynaecomastia in M

A

AROMATASE INHIBITOR

a) Anastrozole

34
Q

When is a UTI deemed complicated?

A 
Man 
Immunocompromised
Recurrent UTI
Pregnant
Structural defect 
Child

MIRPSC

35
Q

Autosomal Dominant Polycystic Kidney Disease is a RF for which emergency event?

A

ADPKD&raquo_space; Berry aneurysm&raquo_space; Rupture&raquo_space; SUBARACHNOID HAEMORRHAGE

36
Q

Erectile Dysfunction management

A

Phosphodiesterase 5 inhibitors - Sildenafil

Also: pulmonary hypertension

37
Q

Pt presents with gross haematuria, flank pain and a palpable abdominal mass.

Likely diagnosis?

A

Renal Cell Carcinoma (90%)

  1. Clear Cell Carcinoma (70% of RCC)
  2. Papillary Cell Carcinoma (10% of RCC)

2A - Stuff i just cannot remember (19 decks)

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